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HomeMy WebLinkAbout3714 MAIN ST./RTE 6A(BARN.) - Health 3714 MAIN ST. RTE 6A ,BARNSTABLE A =317 026 y f I , f No. FCC THE COMMONWEALTH OF MASSACHUSETTS ' Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0(pplication for Mi.5pogar *pgtem Construction Permit Application for a Permit to Construct( )Repair(/)Upgrade( )Abandon( ) ❑Complete System P Individual Components Location Address or Lot No. Owner's^Name,Address and Tel No. Assessor's Map/Parcel 37/ �� V ��eT oprG� � lwo .r(,e Installer's Name,Address,and Tel.No. , Designer's Name,Address and Tel.No. �7/ �9�3 Type of Building: Dwelling No.of Bedrooms t3 Lot Size sq. ft. Garbage Grinder( � Other Type of Building L'diy No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow G/D gallons per day. Calculated daily flow 347 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. 2 !PO'll!PO'lleW !lydjkl'5 Description of Soil; / !2 ZS-Xz2 Nature of Repairs or Alterations(Answer when applicable) /�T6r° 7 le-,P11- Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by his Bo d of ealth. Signed A Date 11r Od Application Approved by. �� Date Application Disapproved for the following reasons Permit No. Date Issued d r Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS..,,x s a Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS "9 Rpplication for Mopool bpotem Congtruction i3ermit Application for a Permit to Construct( )Repair/Upgrade( )Abandon( ) ❑Complete System Individual Components Location Address or Lot No. Owner's Name,Address and TTell No. Assessor's Map/Parcelf �wel— Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. j"9/-lvG411-A/ 77/ Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder ? Other Type,of Building 5/ eda- No.of Persons Showers( ) Cafeteria( ) Other Fixtures ' . 3 Design Flow L/l gallons per day. Calculated daily flow 3134� gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /Oy wl /�X%3�`%rl�i Type of S.A.S. Z ✓�©O �Q D.7 owl �S. Description of Soil / / /Z_ •-�X ZsX�� Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by his Bo d of ealth. J Signed Date Application Approved by Date 3 J_ 0Wr_0 Application Disapproved for the following reasons Permit No. Z�v/� Date Issued ---------- THE COMMONWEALTH OF MASSACHUSETTS -3 j 7~61Z-6 BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CE Y,that the On-site Sewage Disposal System Constructed( )Repaired( V/)Upgraded( ) Abandoned( )by / C'�,e5 at 2i /Y RT Xi.4i Soo/w51"e- ly le has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No._Z'0_0V- /ST) dated Installer Designer fA F/y� e A 6 The issuance of this t sh ll not be construed as a guarantee that the s,, tern w 11 function as d�i ned Date P ,� g Inspector y �1i1.'CI � 1� �"7�`�f �1 .j V No. `cU +...��-------------------�F �—O�i!/ Fee -���...►-"' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS miopogaf bpzteTn�lCongtruction 3permit Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( ) System located at .3 7/!� /?7-XA ACl/'f jz5 Ile and as describe3 in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction midst be completed within three years of the date of this It ,/ k Date:_ �3,/ Approved by TOWN OF BARNSTABLE LOCATION ��� �T�/ SEWAGE # VILL AGE �a t�l�T'Ole ASSESSOR'S MAP & LOT 3/7--e2�12 INSTALLER'S NAME&PHONE NO. Xa114PZ0,1*i 6fes1; SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR( PERMTTDATE: —COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland.-and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 2 �� :. i �� ��� Gi'P ' �2 �y, S� �3_ �� , i � Z&S�s � 3�� � � y-s i i � -- — e �l .�: _ ��K U699 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH ND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERNMIT CWT MOLT DESIGNED PLAINS) L hlnll` 77 46 itereav Certify that the application for disaosai wore, const-uction permit signed by me date d /o/®� conce.-,-ins the property located at 37/ meets ail of the following criteria: 1/ The failed system is connec ed:c a.esidentiai dwei ing oniv. :sere are ao comme:c-im or business Tyhees associated xith the dwelling. sou i cl " / s assuzed as CLASS :and he pe:rcianon rate:s toss than or_:.ual to �� minutes der:acn. . ` v/ iaere are no wetlands within 100 tee;of he pressed septic system 1 here are no private wells within i40 tee;of• e cro�sea se-ptic srste^t i sere is no increase in flow and/or change Ln ±se trot_used Y There are no variances requested or needed L/ The bottom of the proposed leaching'aciity will not be located less than five lee;above he marntum adjusted groundwater table eieraticn. Adjust he;oundwater mble asina the Fr:mrtcr method when applicable] ` ✓ jf the S. 5. will be located with 2d0 e-et of any vegetated wetlands. the bottom of the orct:osr� leaching facility will not be located less than-cuneen(14)fee:above the maximum adiusted groundwater table elevation. Please complete the following: A) Top of Ground Surface Elevation(using GIS information) $` B) G.W. Elevation the WJC F.igh G.W. Adjustment DIFFERENCE BETWEEN A and B SIGNED � DATE: 3 w/©� [Sketch proposed plan of system on back]. q.haltti folds:cart 1 p v tip- ) 3 7�� o TM 04/21/00 13:43 '0308 428 9399 BORTOLOTTI CONST i •�(� g� ` 0itToL � ON, INC. , >, ' - I � �.� I �� .. 1•.. .fir r I DRAINAGE d}. .:LAND UEY� 4 .NT -� ,,: ,'� • SEPTIC SYSTEMS r: 1 xak,. F.� sf! fLE T1 t.' '. ° �N � L F DATE:, �� 1 �� 6 TO: `I Q GI6�G� • I I 3 Number of Pages fiacludin Cover• : h MESSA 1 Ir I ���. I ,,f.r P t -1•s• • rL G . . � � • i Z.K.:i.r�t;f;�.y�S } 7 C f ot!have any y questions regardin th matter,ply ,el free call'the office I r 508-771-9399 or 508-428,3926. D r` num ber s4 g 9399 77 PO. BOX 704 •MARSTONS MIt15, AEHUSET T5 0 64$ :(508)77t-9399 FAX X.(5081 Z6-9399 4. 1. iI 04/21/00 13:44 '0508 428 9399 BORTOLOTTI CONST„ fq:R 7- 6� •.. J ,. ',i•. � It .. � I' '.F .=�'_ '^_ .`nit � I; I � ! � .':is•' • .;, � is j- _ . . I TOWN OF BARNSTABLE LOCATION 71`� ✓�'T SEWAGE .. � j vII.LAGE C11�15%�O�E'_ ASSESSOR'S MAP &LOT.3V —� INSTALLER'S NAME&PHONE N0. 1 _SEPTIC TANK CAPACITY 1`� _... (size) LEACHING FACILITY: (type) L.-- NO.OF BEDROOMS- { BUILDER ORJ 3�13�ZC? COMPLIANCE DATE: PERMTTDATE: ; Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet i Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) - I Furnished by LA I { «I- r.- ppTOWN OF BARNSTABLE k?CATION 37/ `� T�� �p l9 SEWAGE # 6— I-27 / VILLAGE 6fYr.✓ s%)qk ASSESSOR'S MAP & LOT. INSTALLER'S NAME & PHONE NO. V, YBwiO Goa SEPTIC TANK CAPACITY /D " LEACHING FACILITYAtype) '/�''�- k f- (size) 30"20AV9 40 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER- DATE PERMIT ISSUED: DATE .COMPLIANCE ISSUED/ z VARIANCE GRANTED: Yes No '�. . � ,, C64� o�� __ _.__. o O .>�. . _. _. (Y �' /t ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................OF......-.. - Appiiration for Bispnsai1 lVorkli Toustrur#iun Itrrmi# Application is hereby made for a Permit to Construct ( ) or Repair X an Individual Sewage Disposal System at: t..-- MIN---S7 :�.I Art t ........... ............... ............................. ........................ ....... .......... -Location•Address or Lot No. :l..................... .....................................................:.......----•-••-••---•-••........._........ a a Owner S Address J.—.1-Ivnstaller ...... ..................... ......Address .........._..... Type-of Building Size Lott S.g 75G........Sq. feet U Dwelling—No. of Bedrooms_ .Ex anion Attic Garbage Grinder Other—T e of Building No. of persons............................ Showers Cafeteria a' Other fixtures ............................--.._..-__________.d W Design Flow.............,-.._._._........._..._gallons per person per day. Total daily flow............3.70.....................gallons. R� Septic,Tank—Liquid capacity/OAIP-..gallons Length....$........ Width;....,.V..... Diameter________________ Depth..4..-_ns* Disposal Trench—No....4........... Width....1.�............ Total Length..30.� Total leaching area2g_!2-.__...sq. ft. 3 Seepage Pit No..................... Diameter..................... Depth below inlet..................... Total leaching area.................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 04 Percolation Test Results Performed by..R..-VA %%LB Wk.................................... Date.-9`kV1_�_$x/ ..._.......... aTest Pit No. 1...2._.......minutes per-inch Depth of Test Pit....1.6........... Depth to groundwater..... ............... WTest Pit No. 2....:...........minutes per inch Depth of Test Pit.................... Depth to ground water........................ fYi •----------------•-----•-•---- -••-••--.._..--•------....__......._......_......................._.... ._......................._..................-- O Description of Soil.......... -.....C.VAQS-L..........15Af?D•--------i .V� 1,' ..__ ��t ?...................................... i p ------41.1..........��. ' x ............................•--............._-.-...-•---------------•---••-------------.......-•-------••-----------••--------:.. Nature of Repairs or Alterations—Answer when a licable-VI-P.LAIL .0 US Agreement: s� tv�tru CERTIFY It vvr+�oti wit= ALLATION AND N STR1'_; The undersigned agrees to install the aforedescribed Individual`Sew ef�j}po�*lESY 'IM�acccociiance with the provisions of:ITL:; 5 of the State Sanitary Code— The undersigned % eboo place the system in operation until a Certificate of Compliance has been issued by t e board of 1 lth. Signed_a� ...... ----•Date Application Approved By...... .............p D�tc �..L ..la Application Disapproved for the following reasons:--_•....................:....................................................................................... ......--••-----••---•..............•-•----•-••=-••-----._......_..---.......-•----•-• ---...:.----•-•--•.._.:....---•-•-•--•--••--••--------..........-• ............................................. Date PermitNo............. .........!. r`Z. --------- Issued........................................................ Date �— Fxa.'..... C VLI THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH rouat+ ....................OF..... R '.. �t.F,� ...:. Apli tratiun for Bhiposal Works Tontrudion run it Application is hereby made for a Permit to Construct ( ) or Repair (,Y) an Individual Sewage Disposal. System at: 4 7 P714 P e_ 4 MA I N 4:t'__. �/A 0 N) •IC .1 A f��ia f .`..Location-Address .. f: ...--- •^ ....... ... ............or Lot No.• ^............... ........._.. W ... l.�...f :�,_:`�jwner .....- ^• Address... ......,.......................... CR— ----•••-.... .. ... ................................ ............................................•.................................:.................. .... M Installer Address Q7i Type of Building - , Size Lot-�'Z--�-.9a._:7.("..........Sq. feet U g— Expansion Attic ( ) Garbage Grinder ( ) ►., Dwell No. of Bedrooms..... .................. ` Other—Type of Building No. of persons............................ Showers p.t YP g ••---•--.:_...-•---.......-- P ( ) — Cafeteria ( ) Q+ Other fixtures`..........••--••.• •-•••-•...............•.._.._.............. W Design Flow.............. .......................gallons per person per day. Total daily flow............T?4)...•.................gallons. C� Septic Tank—Liquid capacity/r1 A q.gallons Length......`2........ Width:..... . Diameter................ Depth..A- ........ xDisposal Trench--No._._ ........... Width....I!........... Total Length.. Total leaching,area.4 .......sq. ft. 3 Seepage Pit No..................: Diameter.................... Depth below inlet.........ti........ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank 0.4 Percolation Test Results Perfcrmed by.'D,:*r A t�?.r1 A UV � _..... Date...`'l�............................... �4° .-.------•------------ ------� 1.4 Test Pit No. 1...2........minutes per inch Depth of Test Pit....!A.......... Depth�to ground water.....%:............... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---•-••.•.. .... _... ......................................... --••--•.......................................................... O Description of Soil....--.-- a.....en e2e'L.C/ . t�?0 y,.t s��, -h ►t� �) -.._.... ..--..•. U f7 At.,t 0 C_. s'?r^ ". '•-- ....................................................... �- UW ........•...•.............................. --.............--------......._......---------•--•-•----•-------•------•-......--------------•-•-------•--•--------...........•••..........----•.•- Nature of Repairs or Alterations—Answer when applicable.P.1=.1'?i:A(S...__._C-F_`-�.._poo�n.... .................................... ••• -•••-••••. . ....--•••••• ,. .........•.................................•--.......... .. .. Agreement: . The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of AI':L: 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued bye the board Hof health.Signed.�_.A�_u;_:.._,J`�?' 1 _ ' �� ........._.._... ...... ...... ........ ... Date Application Approved B ."� �� {r g.................. Date Application Disapproved for the following reasons:.............................................................................................................. ---------------•---.......--•---......--.............---....-•----...........................------..........................----....-----....................•........•.........•••••................... C Date t Permit No....... �'f..._...... Issued.--•--•.............................................._ Date THE COMMONWEALTH OF MASSACHUSETTS ---'''BOARD OF -HEALTH .....................!... .........O F.......... .. .................. Trrtif iratr of Toutphattrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.........-••.........••••...... � ..........- ;�..-------••-•••• • ••...... ........_..-•••-.._..-••-••-•..................•--•-............................. /•- •_ 7 ( �� .3-_t_slaller � ����t at............. . A s - ..........�...__.... ----•------....---...-- --s ........-------•---•---................ has been installed in accordance with the provisions of T1TL-E-i-LE 5 of The State Sanitary Code as;described in the application for Disposal Works Construction Permit No.... 7.:-........._2-r7_L/ dated.......1..� _�.`-f� t� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. c � DATE............................._.....:--•...---•••..............-----•.......... Inspector....... - { .::....:.............................. ---------------------- - THE COMMONWEALTH OF MASSACHUSETTS ,,,,,_.,...._�---- BOARD OF HEALTH No.::70...] t 7Y FzE........ r Disposal Works Tontrurtion f rrntit Permission is hereby granted............. __ �' ►`��; 5:.. ... to Construct ( ) or Repair ( \) an Individual Sewage Disposal System at No............. `f.............. � Cc�A --•--- t-( r�� {--------..... ._....?��.-•---------•-••-----........ ---- . ......... .......•--• .... Street as shown on the application for Disposal Works Construction Permit No ..`.�_Z`fbated.._...._ ...........................l � �• Board of Health DATE..--------r-•---------------------------------------'..........................- SECTION SEWAGE DESIGNI SIG ENGINEER MUST SUPERVISE , SE'�f3AGkS; INSTAL[ TION AND CERTIFY IN WRITII'ir —SEPTIC TANK — 2O —"D"BOX — JS —LEACHUFAILNES TOP OF FDN �Li-r �' THE SYSTEM WAS INSTALLED IN STR1::" ACCOFZ/DANCE TO PLAN. (MSL)a ..2..OF 1ieTO 4:.. WASHED STONE b 2 a1TF IN.• OUT• IN. _ G -_' q L� G OUT. IN- - 22,U0 22,Z7 SEPTIC ` PAYIr7 POI/ / 8 TANK \ a 0D7i 21 �S/ELEV. ELEV. ELEV. ELEV. •,< • 6\ ELEV. ELEV. . .. OF YA •.1V2 WASHED STONE '�iiooOZot�l.E L \: tj�A TEST HOLD LOG � ' 'r �� N . 14 �Yw _. TEST BY V_rA19.&A►,-IIC_P.C. -<<'LAGILEAtt�- WITNESS A TEST DATE. 9 17 SlD QA - DESIGN _BEDROOM HOUSE i / }` <s �� /6 T.H. 1 T.H. +� 2 ELEV.Z t.o ELEV. f PERC RATE MIN/IN. DISPOSER DISPOSER " , (, Y g (� DA II D 1JI b E 1.1/12 �d t1(3 OII/ Iq.o FLOW RAT (GAL./DAY) 3O SEPTIC TANK 330 C ARS REO'D SEPTIC TANK SIZE166e) , ( : � . - E � . * 4 L ACH FACILITY 2 - SIDE WALL: 3ro 2 ,S _ (2,5') 30r7. G/D. �` laEiItE17 I. V BOTTOM /.ZO t C.o - _TOTAL m USE: FdLJ Q LA) LEACHING v' I�nt�lla :y v-110 `(ol( Dr P �7/ott ct�ats4RSl Yam. m WATER ENCOUNTERED --��- yt Iya r m- t A R t ;IiOltj. NOTES: (UNLESS'OTHERWISE'NOTED) 1.DATUM(MSU«TAKEN FR M L QUADRANGLE MAP _ n,` 2.MUNICIPAL WATER — —_.AVAILABLE _ ASH OF , F r1�t� GA 3.PIPE PITCH:Vd'PER FOOT , r yn«' 4.DESIGN LOADING FOR ALL PRECAST,UNITS:AASHO-. f 5.MIN.GROUND COVER OVER44 �4 SG {rp ARNE H f ALL�EWAGE FACILITIES.(1)FT. •,.' � ._,_-_ %::'>'f•`?.;:�. � s - - n? 6.PIPE JOINTS SHALLBE MADE WATER TIGHT p WALA 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH ONIM. F CIVIL �� - CWI� TR+E C O MASS. :t �. Q P17i x:. No:`30T92 r `�K,OF AO r ,h .•,*� -. ITE l ' STATE ENVIRONMENTAL CODE TITLE S 1 . ra PLAN ]. j $.:MIuIMUFn:"PI?��l..�a'C'rEJg":Fo .� /��`�" y 5T' p ;�• o ,ARNE G LOCUS 37Iq"'-TZ[)1`����t loA'.T3!421:.K'1��I�E A _ �. . ., '1♦ ;1 .- ..v .. ,.. -, _ .... .. •,, - ... S - �f ;� i.+^e A+.ai'� M?:.n:1w,4 -r a�L — ------ 2Lf1 OJAi74 Ern-2CAe1A� 31Z� �=KiL..- , 71 1Z REG.P ESSIONAL ENGINEER EIL.t 1+J - fix'W-4JO1.1-ro IAA pLCS. ; 48 'REF: �'i dD`IC B�` iPA(�� "!O �, F; o��-„�R�eaT� .cnis�rtLvct- 0 M�� - �12, .. fst..-•: _.•� ,.-.' �... � _ ".` � i '4{ ry. . .. a down -ca D F I'- ,'� r• -.PRE.ARED:FOR: )QY .� r•4,u, �z, ,•- ., vl A . IAA tL-R�..;wt ... ]. A :i 1. .v 4 `0., .. ..n ... e .Ji ..+. r ,.-' .. _ ... •- -. .: .. .. n.,.. :. .. :-:,T,.,. .'ti,.. .(.-aQ'I{pn I' i s,t M .-''e { __ ,_ .. .,, _. . . ,x .. . ., .,CIVI . EN INEE " : .. �• �.�<: •TQ. - ,. BORRDOF.HEA TH .- _. �. ._. ..r ... _. :. ,... EXISTING _w.._ _:._ _.__. ._:...----- ,. .: ,,. :< < ! , ,. , ._ r `�. - -�- . .,•�• { � D SURVEYOR �. CON RS ,...-, PRO APPROVED SCALE' `L DATE ii MA _. may}•' '.L .- -:•F'.b�. �+b..,+T t0. ,�: , h .. - -. .. .. ... � .. i i. •�w�wwfi�. ,. ..., .. -,.- $.'. ,x s:.i 1:. :q ..$:.:-. } r Y y ..,. - ..,. . , v:^: •,• ,.--.^,a 1.Lh -5i- :-.:fit^`.. n,. .. :' ti•-.1 il '..r+ tq, a?< .w, c n" 2:.�'.r�' �`i. r r _E�4'�_.�±1.:];��:.*. 4 RIP *'4.